| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MFB FINANCIAL DBA THE BAILEY GROUP3 | 1200 PLANTATION ISLAND DRIVE STE 210 ST AUGUSTINE, FL 32080 | STANDARD LIFE INSURANCE COMPANY | $102K | — | $102K | 21.63% |
| PAYCOM PAYROLL LLC3 Filed as: PAYCOM PAYROLL HOLDINGS LLC | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | STANDARD LIFE INSURANCE COMPANY | — | $17K | $17K | 3.50% |
| MFB FINANCIAL INC3 Filed as: MFB FINANCIAL | 1200 PLANTATION ISLAND DRIVE STE 210 ST AUGUSTINE, FL 32080 | AETNA LIFE INSURANCE CO. | $27K | — | $27K | 25.49% |
| MFB FINANCIAL INC3 Filed as: MFB FINANCIAL | 1200 PLANTATION ISLAND DRIVE STE 210 ST AUGUSTINE, FL 32080 | HUMANA INSURANCE COMPANY | $4K | — | $4K | 6.35% |
| REBECCA J SMITH INC4 | 2557 MICHAELSON WAY JACKSONVILLE, FL 32223 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $4K | — | $4K | 25.30% |
| LIVING LEGACY BENEFITS GROUP LLC4 | 1170 PALM LAKE DR APT 122 JACKSONVILLE, FL 32218 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $88 | — | $88 | 0.51% |
| KATHLEEN DEANNE NORTON LLC4 | 6050 GREEN POND DR JACKSONVILLE, FL 32258 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $64 | — | $64 | 0.37% |
| MARC S MILLER4 Filed as: MARC MILLER | 9802 BAYMEADOWS RD #12 JACKSONVILLE, FL 32256 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $55 | — | $55 | 0.32% |
| AMELIA T HAMILTON4 | 1120 N MAIN ST WINNSBORO, TX 75494 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $51 | — | $51 | 0.30% |
| BROOKE B. WARD4 Filed as: BROOKE B WARD | 2557 MICHAELSON WAY JACKSONVILLE, FL 32223 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $35 | — | $35 | 0.20% |
| STEVEN M. MURRISON4 Filed as: STEVEN M MURRISON | 502 S ESTATED DR SALINA, KS 67401 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $26 | — | $26 | 0.15% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 680 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 129 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 814 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | HUMANA INSURANCE COMPANY | 418 | $68K |
| Life insurance | STANDARD LIFE INSURANCE COMPANY | 716 | $471K |
| Short-term disability | STANDARD LIFE INSURANCE COMPANY | 716 | $471K |
| Long-term disability | STANDARD LIFE INSURANCE COMPANY | 716 | $471K |
| Other | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | 117 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 716 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.